Optical Coherence Tomography-Guided Percutaneous Coronary Intervention: Evidence and Clinical Trials

Intracoronary imaging is beneficial to optimize stent implantation and reduce the risk of stent-related complications. Optical coherence tomography (OCT) is an intravascular imaging modality that allows for detailed microstructural evaluation during the percutaneous coronary intervention (PCI). Recently, several large-scale registries, randomized trials, and meta-analyses have shown the superiority of OCT to angiography and noninferiority to IVUS with respect to both acute procedural results and mid-term clinical outcomes. This article summarizes the data supporting the application of OCT-guided PCI to several specific situations, introduces important evidence, and discusses the ongoing controversies and limitations of the current evidence base in the field of OCT-guided PCI.